Abstracts

Rationale: Temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) is often related pharmaco-resistant form of epilepsy. Among TLE-HS features we found a progressive behavior evolution, in which there is the association between initial precipitating incidents (IPI) and the beginning of spontaneous seizures. Changes in cytokines levels have been studied in experimental models and patients with epilepsy. Because inflammatory mechanisms could participate in TLE-HS epileptogenesis we decided to analyze plasma levels of tumoral necrosis factor alpha (TNF-α) and receptor type 1 (TNFR1) and transforming growth factor beta (TGF-β1) in operated and not operated patients with TLE-HS. Methods: We included a total of 19 patients with TLE-HS and 42 healthy controls. Patients with TLE-HS were underwent a comprehensive investigation. Eight of the 19 TLE-HS were submitted to anterior temporal lobectomy and became seizures free. The blood samples collected were carefully done in the absence of clinical and laboratorial signs of infection or inflammatory process. The analyses of TGF-β, TNF-α and TNFR follow the ELISA protocol described by the manufacturer (PeproTech INC, Rocky Hill, NJ). The results in pg/ml were calculated from a curve standard gotten for calipers of the recombinant cytokines. The studied variable had been registered in spread sheet of Program EXCELL. The patients had been divided in different groups for analysis of the variable associates, and the difference between the joined values was analyzed by test t of student. Statistical differences of cytokine levels between patients and healthy controls were tested using the Mann-Whitney test was considered values of p< 0, 05. Results: All patients submitted to the anterior temporal lobectomy were seizures free conversing with the TLE-HS group of not operated patients who presented a severe frequency of seizures (mean 6,5 crises/month (minimum of 2 and 4,44 maximum, median of 4).There was a significant correlation with IPI and hypersignal in TLE-HS patients’ magnetic resonance (p=0.002). We observed higher serum levels of TGF-β1 in TLE-HS epileptic patients (p=0.008) when compared with controls. The TNF-α and TNFR1 levels were increased in TLE-HS patients compared with controls neverthless there wasn’t any statistic correlation on cytokines levels between surgical and non-surgical TLE-HS patients. The free level of TNF-α observed in theTNF-α/TNFR1 ratio was lower in the operated TLE-HS patients compared to the not operated group (p<0,05). Conclusions: The plasma levels of cytokines TNF-α, TGF-β1 e TNFR1 in patients with TLE-HS were significant related with the disease compared with healthy controls and that the seizures frequency didn’t change the expression of those cytokines in TLE-HS patients. Moreover, free TNF-α level was decreased in the absence of seizures in TLE-HS operated patients